Ilizarov Apparatus - History

History

Ilizarov used external fixation devices on patients to treat non-unions in the 1950s. Ilizarov observed the callus formation and discovered distraction osteogenesis when one patient lengthened his frame instead of compressed it. The procedure, and the first apparatus he designed for it, was inspired by a shaft bow harness on a horse carriage (see photo to the right). Originally bicycle parts were used for the frame.

The technique gained fame across the Soviet Union when he successfully treated Soviet world-record holder, and gold medalist high jumper, Valery Brumel in 1968. Brumel broke his tibia in a motorcycle accident and had 20 unsuccessful operations over a three-year period to try to repair his non-union. Ilizarov used distraction osteogenesis to heal the non-union and 3.5 cm (1.4 in) leg length discrepancy.

Ilizarov gained more fame in 1980 when he successfully treated Italian journalist and adventurer, Carlo Mauri. Mauri had broken his leg in a skiing accident ten years earlier and his tibia never properly healed. When he was on an expedition across the Atlantic, the wound on his leg reopened and Russian doctor advised him to see Ilizarov. When Mauri returned to Italy after his treatment, Italian doctors were impressed that his tibial non-union was repaired. They invited Ilizarov to speak at the Italian AO Conference in Bellagio. This was the first time Ilizarov spoke outside of the "Iron Curtain.

The technique was brought to the US in 1987 by Victor Frankel, president of Hospital for Joint Diseases.

The Ilizarov external fixators can be used to correct angular deformity in the leg, to correct leg-length differences, and treat non-unions. In most developing countries it is a highly specialized technique used mainly for deformity correction by experienced surgeons due to its complexity. Further development of the ring construct led to the Taylor Spatial Frame which is more versatile and far easier to use, but very costly. Intramedullary limb lengthening devices are also available, but they are not suitable for deformity correction of bones.

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